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It is kind of frightening when cancer does not fit into the rule book. Painless lump is the usual presentation in breast cancer. So, when a 31 year old walks into your clinic with an exquisitely tender lump and an ultrasound report proclaiming it to be an abscess in evolution, you are tempted to believe it. However the antenna that you nurture carefully with years of experience tells you otherwise..THIS IS JUST NOT RIGHT.....The tender lump, the tender round lymph node. A repeat ultrasound done by my radiologist colleague and a core biopsy confirm my worst fears.. I am dealing with cancer in this unsuspecting young lady. Breaks my heart but I have a job to do!
WHO TREATS BREAST CANCER? It is not unusual to see patients visiting their gynecologists/obstetricians with a breast complaint before they are guided to a breast surgeon or specialist.While Germany is one of very few countries where gynecologists deal with breast diseases as well as gynecological diseases, breast diseases are treated by surgeons in India. Breast cancer needs to be detected early to get the best of results and any suspicious lump should be brought to the notice of a breast cancer specialist at the earliest. For further details, please contact Dr Geeta Kadayaprath, Head, Breast Cancer Services, Max Hospital, Patparganj.
Early breast cancer does not usually announce its presence with pain. The most common presentation of Breast cancer is a PAINLESS LUMP! Please do not ignore such a lump and see a Breast surgeon to make sure it is nothing sinister!
SURGERY FOR BREAST CANCER IS NOT ABOUT REMOVING BREASTS, ALWAYS… When 32 year old Neena, an HR consultant in an MNC, walked into my clinic, accompanied by her husband and parents, I could sense an air of hopelessness surrounding this good looking young lady. The papers that were laid in front of me carried a needle biopsy report, which confirmed the diagnosis of breast cancer. Fortunately, for her, the size of the lump was about 2cms and there were no lymph nodes that I could feel in the armpit. There was no evidence of spread to the other organs on imaging. I soon realized she had been through the discussion of surgery and she had come to me for a second opinion. I soon found out why she had decided to come for a second opinion. She had been advised a modified radical mastectomy (complete removal of the breast along with the lymph nodes in the armpit). She was a successful career woman with everything going for her till yesterday and today she was grappling with this tough predicament- losing an organ, an integral part of her feminity to cancer- it was almost cruel!.......... ....To be continued.....watch this space for more.......
SURGERY FOR BREAST CANCER IS NOT ABOUT REMOVING BREASTS, ALWAYS… While all this continued as the standard of care for the first 65 years of the 20th century, some smart minds in the medical field started questioning the necessity of performing such radical surgeries to get optimum results. Trials got underway to compare mastectomy versus breast conservation surgery in the 1970s. A pathologist turned surgeon, Dr Umberto Veronesi, pioneered the most convincing trial in Milan. He was able to show that breast conservation surgery (removal of the lump with a surrounding 1 cm margin of normal breast tissue) followed by radiation therapy to the rest of the breast in properly selected patients yielded the same results as a complete removal of the breast. I am quite convinced that it is the pathologist in this surgeon who urged him to go for this trial. He had probably seen while looking at the breast as a pathologist that far too much was being done to address small cancers in the breast. Finally, women with breast cancer had a choice…. For more information on breast cancer, please contact Dr Geeta Kadayaprath, Breast Surgeon, Max Cancer Centre, Delhi, India
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